Exercise in patients with acetabular retroversion and excessive anterior pelvic tilt: A feasibility and intervention study.


Journal

Musculoskeletal science & practice
ISSN: 2468-7812
Titre abrégé: Musculoskelet Sci Pract
Pays: Netherlands
ID NLM: 101692753

Informations de publication

Date de publication:
10 2022
Historique:
received: 02 01 2022
revised: 15 06 2022
accepted: 18 06 2022
pubmed: 2 7 2022
medline: 9 9 2022
entrez: 1 7 2022
Statut: ppublish

Résumé

Acetabular retroversion is associated with femoroacetabular impingement syndrome (FAIS). Anterior pelvic tilt enhances risk of FAIS. To investigate feasibility and change in patient-reported symptoms of a home-based exercise intervention in patients with acetabular retroversion and excessive anterior pelvic tilt, in comparison with a prior control period. Prospective intervention study. Patients (18-40 years) not eligible for surgery, with radiographic signs of acetabular retroversion and excessive anterior pelvic tilt were recruited. An 8-week control period was followed by an 8-week training period. The home-based intervention consisted of education and exercises for core stability, muscle strengthening and stretching for reducing anterior pelvic tilt. Feasibility assessments were dropout (≤10%), adherence (≥75% of sessions), exercise-related pain, and adverse events. Primary outcome was change in the Copenhagen Hip and Groin Outcome Score (HAGOS) pain-subscale. Pelvic tilt was measured by EOS scanning. Forty-two patients (93% female, mean age 22.2 ± 4.2 years) were included. Dropout rate was 7% and satisfactory adherence was demonstrated by 85%. Exercise-related pain and adverse events were acceptable. Between-period mean change score for HAGOS-PAIN was 5.2 points (95% CI: -0.3-10.6) and -1.6° (95% CI: -3.9-0.7) of anterior pelvic tilt. Patients responding positively (≥10 points) (n = 10, 26%), had pre-exercise moderate pain (HAGOS-PAIN 47.5-70 points). Current exercise intervention was feasible. However, we found no clinically relevant changes in self-reported hip-related pain or anterior pelvic tilt. Post hoc responder analysis revealed that patients with moderate pain at baseline might benefit from this exercise.

Sections du résumé

BACKGROUND
Acetabular retroversion is associated with femoroacetabular impingement syndrome (FAIS). Anterior pelvic tilt enhances risk of FAIS.
OBJECTIVES
To investigate feasibility and change in patient-reported symptoms of a home-based exercise intervention in patients with acetabular retroversion and excessive anterior pelvic tilt, in comparison with a prior control period.
DESIGN
Prospective intervention study.
METHODS
Patients (18-40 years) not eligible for surgery, with radiographic signs of acetabular retroversion and excessive anterior pelvic tilt were recruited. An 8-week control period was followed by an 8-week training period. The home-based intervention consisted of education and exercises for core stability, muscle strengthening and stretching for reducing anterior pelvic tilt. Feasibility assessments were dropout (≤10%), adherence (≥75% of sessions), exercise-related pain, and adverse events. Primary outcome was change in the Copenhagen Hip and Groin Outcome Score (HAGOS) pain-subscale. Pelvic tilt was measured by EOS scanning.
RESULTS
Forty-two patients (93% female, mean age 22.2 ± 4.2 years) were included. Dropout rate was 7% and satisfactory adherence was demonstrated by 85%. Exercise-related pain and adverse events were acceptable. Between-period mean change score for HAGOS-PAIN was 5.2 points (95% CI: -0.3-10.6) and -1.6° (95% CI: -3.9-0.7) of anterior pelvic tilt. Patients responding positively (≥10 points) (n = 10, 26%), had pre-exercise moderate pain (HAGOS-PAIN 47.5-70 points).
CONCLUSIONS
Current exercise intervention was feasible. However, we found no clinically relevant changes in self-reported hip-related pain or anterior pelvic tilt. Post hoc responder analysis revealed that patients with moderate pain at baseline might benefit from this exercise.

Identifiants

pubmed: 35777262
pii: S2468-7812(22)00113-8
doi: 10.1016/j.msksp.2022.102613
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102613

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declarations of competing interest None.

Auteurs

Anders Falk Brekke (A)

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark; University College Absalon, Center of Nutrition and Rehabilitation, Department of Physiotherapy, Region Zealand, Denmark. Electronic address: afbrekke@health.sdu.dk.

Søren Overgaard (S)

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark. Electronic address: soeren.overgaard@regionh.dk.

Bo Mussmann (B)

Department of Clinical Research, University of Southern Denmark, Denmark; Department of Radiology, Odense University Hospital, Denmark; Faculty of Health Sciences, Oslo Metropolitan University, Norway. Electronic address: Bo.Mussmann@rsyd.dk.

Erik Poulsen (E)

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark. Electronic address: epoulsen@health.sdu.dk.

Anders Holsgaard-Larsen (A)

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark. Electronic address: AHLarsen@health.sdu.dk.

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